<!DOCTYPE html>
<html lang="zh" xmlns:th="http://www.thymeleaf.org" >
<head>
    <th:block th:include="include :: header('修改服务商提供发票记录')" />
</head>
<body class="white-bg">
    <div class="wrapper wrapper-content animated fadeInRight ibox-content">
        <form class="form-horizontal m" id="form-InvoiceRecord-edit" th:object="${invoiceRecord}">
            <input name="id" th:field="*{id}" type="hidden">
            <div class="form-group">    
                <label class="col-sm-3 control-label">服务商编号：</label>
                <div class="col-sm-8">
                    <input name="agentNum" th:field="*{agentNum}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">发票抬头：</label>
                <div class="col-sm-8">
                    <input name="invoiceTitle" th:field="*{invoiceTitle}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">发票税号：</label>
                <div class="col-sm-8">
                    <input name="invoiceNumber" th:field="*{invoiceNumber}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">发票内容：</label>
                <div class="col-sm-8">
                    <input name="invoiceContent" th:field="*{invoiceContent}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">开票联系方式：</label>
                <div class="col-sm-8">
                    <input name="linkPhone" th:field="*{linkPhone}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">发票金额：</label>
                <div class="col-sm-8">
                    <input name="invoiceMoney" th:field="*{invoiceMoney}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">抵分润税点税票时间，按月：</label>
                <div class="col-sm-8">
                    <input name="creationDate" th:field="*{creationDate}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">分润税金额：</label>
                <div class="col-sm-8">
                    <input name="creationMoney" th:field="*{creationMoney}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">税票凭证地址：</label>
                <div class="col-sm-8">
                    <input name="taxVoucher" th:field="*{taxVoucher}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">申请日期：</label>
                <div class="col-sm-8">
                    <input name="createDate" th:field="*{createDate}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">分润返还时间：</label>
                <div class="col-sm-8">
                    <input name="returnDate" th:field="*{returnDate}" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">状态：1申请 2受理中 3 已完成 4 失败：</label>
                <div class="col-sm-8">
                    <div class="radio-box">
                        <input type="radio" name="status" value="">
                        <label th:for="status" th:text="未知"></label>
                    </div>
                    <span class="help-block m-b-none"><i class="fa fa-info-circle"></i> 代码生成请选择字典属性</span>
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">备注信息：</label>
                <div class="col-sm-8">
                    <input name="remarks" th:field="*{remarks}" class="form-control" type="text">
                </div>
            </div>
        </form>
    </div>
    <th:block th:include="include :: footer" />
    <script th:inline="javascript">
        var prefix = ctx + "InvoiceRecord/InvoiceRecord";
        $("#form-InvoiceRecord-edit").validate({
            focusCleanup: true
        });

        function submitHandler() {
            if ($.validate.form()) {
                $.operate.save(prefix + "/edit", $('#form-InvoiceRecord-edit').serialize());
            }
        }
    </script>
</body>
</html>